NPI | 1992133433 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 006993) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 006993) |
Enumeration Date | 2013-10-18 |
Last Update Date | 2023-11-15 |